How Does Nicotine Replacement Therapy Work?

This blog is provided for general educational purposes only and is not intended to promote or advertise any therapeutic good

Nicotine replacement therapy (NRT) is one of several evidence-based approaches used to support smoking cessation. If you’ve tried to quit smoking before, you may already be aware that managing nicotine cravings and withdrawal symptoms can be one of the more challenging aspects of quitting.

How Nicotine Affects the Brain
Cigarettes contain nicotine, which is rapidly absorbed through the lungs and reaches the brain within seconds. Nicotine stimulates the release of dopamine- a neurotransmitter associated with feelings of reward and reinforcement.

When a person stops smoking, nicotine levels in the body drop. This can lead to withdrawal symptoms such as cravings, irritability, difficulty concentrating, restlessness and anxiety.

Nicotine replacement therapy is intended to reduce withdrawal symptoms by providing controlled doses of nicotine without exposure to the harmful chemicals found in tobacco smoke.

Types of Nicotine Replacement Therapy
NRT products deliver nicotine at different speeds and in different formats. They are generally divided into:

Fast-Acting NRT
These products deliver nicotine more quickly and may help manage sudden cravings. Examples include:

• Nicotine gum
• Lozenges
• Mouth sprays
• Inhalers

Although these products work faster than patches, they do not deliver nicotine to the brain as rapidly as cigarettes.

General Use Considerations
When using oral NRT products:

• Avoid eating or drinking while using them.
• Avoid acidic drinks (such as coffee, soft drinks or fruit juice) for at least 15 minutes beforehand, as they may reduce nicotine absorption.
• Follow the instructions provided with the product carefully. Proper technique helps ensure nicotine is absorbed through the lining of the mouth as intended.

Long-Acting NRT
Nicotine patches are applied to the skin and deliver a steady dose of nicotine over 12–24 hours. They are designed to reduce ongoing cravings throughout the day.

Some people use combination therapy, where a patch provides steady background nicotine while a fast-acting product is used for breakthrough cravings. Healthcare professionals can advise whether this approach is suitable based on individual circumstances.

Safety and Side Effects
NRT is generally well tolerated. Possible side effects may include:

Oral products (gum, lozenges, sprays):

• Mouth irritation
• Hiccups
• Nausea
• Heartburn

Patches:

• Skin irritation
• Vivid dreams
• Sleep disturbances

These effects are usually temporary. Always read the product information and consult a healthcare professional if you are unsure whether NRT is appropriate for you, particularly if you are pregnant, breastfeeding, under 18, or have underlying medical conditions.

Making an Informed Decision
There are multiple approaches to quitting smoking, and no single method works for everyone. Evidence-based options may include behavioural support, nicotine replacement therapy, and prescription medicines.

A healthcare professional can help assess your medical history, smoking patterns and preferences to determine which approach may be appropriate.

Disclaimer
Nicotine replacement therapies are therapeutic goods regulated in Australia. They should be used according to product instructions or healthcare advice.

There are several approaches to smoking cessation, and individual suitability varies. If you are unsure which option is appropriate for you, speak with a qualified healthcare professional.